House Committee on Education and Labor
U.S. House of Representatives

Current federal mental health parity protections have made significant improvements in mental health coverage by striking a balance that provides important mental health benefits to patients without placing unworkable mandates on employers. Republicans have focused mental health parity reform efforts on workable solutions that will not jeopardize workers’ existing health care benefits or discourage employers from voluntarily providing quality benefits to their employees.  This same approach has been taken in the U.S. Senate, where a bipartisan coalition that includes the employer community, insurers, and mental health stakeholders has developed and passed consensus legislation that strengthens opportunities for patients to receive needed care while protecting the employer-based health care system.

Unfortunately, House Democrats have rejected the bipartisan approach taken in the Senate, opting instead for an over-reaching measure that would saddle employers with more costly mandates and threaten health care coverage for American workers.  The bill approved by the Education and Labor Committee last year is riddled with new federal mental health benefit mandates on employers, many of which exceed those applied to other types of similarly severe medical illnesses.  For example, under the House Democrat bill, virtually every mental illness defined by the mental health profession would be required to be covered by plans, even though most states currently do not mandate this type of coverage.  The bill applies no similar requirement on any other category of benefits covered by a plan, including hospital services, physician services, and prescription drug benefits.  In addition:

•    The bill fails to adequately protect medical management practices that are currently being used by private plans to help ensure high quality, affordable medical care;

•    The legislation approved by the Education & Labor Committee weakens key requirements in the Employee Retirement Income Security Act (ERISA), potentially subjecting health plans to as many as 50 state laws on mental health benefits, making it more difficult to provide consistency in coverage;

•    It mandates out-of-network coverage if any other benefit is offered on an out-of-network basis, which will effectively prohibit carve-out plans for mental health and substance abuse coverage even though these specialty providers have been particularly effective in advancing appropriate and cost-effective care; and

•    The bill will increase litigation against ERISA plans by permitting application of state remedies to federally-mandated benefits.  As a result, there will be no consistency in state court rulings, causing litigation costs to skyrocket. 

The flaws in the House Democrat bill would thrust upon employers more mandates, more costs, and more reason to restrict worker coverage or flee the voluntary benefits system altogether.  Republicans support the bipartisan approach taken in the Senate, which:

•    Does not mandate that health plans cover specific mental health benefits;

•    Clarifies that medical management of mental health benefits is not prohibited; and

•    Assures a uniform federal rule – through ERISA – for the comprehensive and strong mental health parity benefits provided by the bill.

Republicans have worked to develop sensible reforms to ensure parity between mental health and medical/surgical benefits provided by employer-sponsored health insurance plans.  The Republican alternative, defeated during Education and Labor Committee consideration of the bill, is based on legislation approved by the Senate that is the product of two years of bipartisan negotiations between a broad, well-respected group of Senators, mental health advocates, providers, and business groups, who represent virtually all interests in this debate.  These groups negotiated in good faith on many difficult issues, resulting in a compromise that meets the needs of all stakeholders.  If Democrats are serious about enacting mental health parity this year, they should embrace the bipartisan reforms found in the Senate bill to provide real parity between the coverage of mental and physical illnesses.

#####